ARAÚJO, H. P.; SALGADO, R. F.; http://lattes.cnpq.br/8242623368057754; SALGADO, R. F.; ARAÚJO, Hugo Pinheiro de; ARAÚJO, Raquel Ferreira Salgado de
Resumo:
Chikungunya is characterized by fever episodes
associated with intense and debilitating joint pain, headache and myalgia.
Although it presents with Dengue-like symptoms, the presence of
polyarthritis/symmetric arthralgia (mainly affecting wrists, ankles and elbows),
which usually improve after 10 days though may last for months after the fever
episodes, calls attention. Prevalence rates of chronic cases varied throughout
different epidemics in France, South Africa and islands of Indian Ocean, ranging
from 4 to 63%. The emergence of arboviruses in previously inert locations stands
as a potential public health challenge through many aspects. Aim: To observe the
prevalence of chronic manifestations of Chikungunya in different countries over
the world and comparing them. Methods: This study consisted of a systematic
review of either prospective or retrospective cohort studies covering suspected
Chikungunya patients, published in American, European, African and Asian
countries, from 2006 up to 2017. Such studies were selected through MEDLINE,
LILACS and Scielo databases, based on Virtual Health Library (VHL) search
system. Initially, 327 studies were found, however after applying the inclusion and
exclusion criteria, 7 articles were finally selected. Results: The present study
included 1,348 participants who presented with Chikungunya diagnosis elucidated
by PCR technique, ELISA or clinical criteria aging between 15 and 80 years, being
mostly females. The time elapsed since the diagnosis of Chikungunya until the
symptoms evaluation ranged from 1.5 to 27.5 months. Chikungunya prevalence
was 15.84% (n=8,508) of the total sample of patients with suspected disease and
the prevalence of chronic joint pain was 44.36% among patients with diagnosis
confirmation (n=1,348). Conclusion: Most studies defined chronic disease as
manifestations of disease after three months from the initial symptoms. The profile
of patients with Chikungunya and chronic articular manifestations found in this
review was compatible with the world literature. The prevalence of chronic
arthralgia was higher in females. It was not possible to conclude whether previous
joint disease or comorbidities were related to the increased chronicity of joint
symptoms. Additionally, it was not possible to associate joint inflammation with the
prolonged presence of the virus in the joint, as some studies suggest.